Topic Contents

Covers use of corticosteroids to treat rheumatoid arthritis. Lists generic and brand names such as triamcinolone (Aristospan) and prednisolone. Looks at how well they work. Lists possible side effects when corticosteroids are used for a long time.

Corticosteroids for Rheumatoid Arthritis

Examples

Generic Name

Brand Name

dexamethasone

Decadron

methylprednisolone

Depo-Medrol, Medrol

prednisolone

prednisone

triamcinolone

Aristospan

These medicines can be taken by mouth (orally). Shots
(injections) of steroids into the joint may be used to relieve pain and
swelling in a joint.

How It Works

Corticosteroids are medicines similar to
natural hormone substances produced by the body that help to reduce
inflammation. They are effective in reducing disease
activity in
rheumatoid arthritis.

One way
corticosteroids reduce inflammation is by decreasing the action of the body's
immune response. Although this effect can help relieve pain and swelling, it
may make you more susceptible to infection.

Why It Is Used

Corticosteroids are used to control
inflammation caused by rheumatoid arthritis.

Corticosteroids
are used:

In low doses to control inflammation as "bridge
therapy" when starting disease-modifying antirheumatic drugs (DMARDs) until the
DMARDs become effective.

To treat sudden flares of joint
pain.

For short-term relief (weeks to months) in inflamed
joints.

In low doses for longer periods, for people who do not respond to other DMARDs.

For severe symptoms such as inflammation of the sac around the heart (pericarditis) or the blood vessels (vasculitis).

How Well It Works

Use of corticosteroids has been found to be effective in reducing inflammation caused by rheumatoid
arthritis.
Corticosteroids are usually used at the lowest dose and for the shortest amount of time possible.1

Corticosteroid shots into
inflamed joints can relieve pain and increase function for some people. This relief may last from weeks to months.2 In general, the
same joint should not be injected more than once every 3 or 4 months.

Side Effects

Serious side effects often occur when
corticosteroids are used for long periods of time. These include:

Uncommon and irreversible (permanent) side
effects, such as:

Softening or destruction of the hip, knee,
wrist, or foot joint (osteonecrosis).

See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)

What To Think About

Long-term use of corticosteroids is not recommended because of their serious side
effects.

To prevent osteoporosis while taking long-term
corticosteroids, get plenty of
calcium and
vitamin D, and consider a preventive medicine, such as
alendronate or risedronate. To come up with a plan that fits your needs, you
may want to work with your doctor or a
registered dietitian. Weight-bearing exercise also
helps reduce the risk of osteoporosis. For more information, see the topic
Osteoporosis.

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